Provider Demographics
NPI:1750591780
Name:W. FORREST BRYANT, DMD PC
Entity type:Organization
Organization Name:W. FORREST BRYANT, DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:W
Authorized Official - Middle Name:FORREST
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-350-2047
Mailing Address - Street 1:1318 STRATFORD RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6026
Mailing Address - Country:US
Mailing Address - Phone:256-350-2047
Mailing Address - Fax:256-350-9577
Practice Address - Street 1:1318 STRATFORD RD SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6026
Practice Address - Country:US
Practice Address - Phone:256-350-2047
Practice Address - Fax:256-350-9577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL48281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty